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6; '` <br /> L.`kr'-. 'q 1"` 3 1- g' r-i � _ <br /> I will be installing the following: <br /> Tan <br /> Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: <br /> Ltc.ti. 01-. 2Kt57(t....j 2 4.A„.., <br /> AI ',Ilk) Size of Tanks: /000 (000 /o 00 <br /> Treatment System <br /> \/ Trenches s.f. <br /> Mound 1770 s.f. /o � y/ ' <br /> Gravel less s.f. <br /> Chamber s.f. <br /> Final Cover/ Top Soil <br /> to be borrowed from site (show location on site plan) <br /> trucked in <br /> The undersigned hereby applies to the City of Orono for issuance of a septic system <br /> installation permit, agrees to do all the work in strict accordance with ordinances of the City <br /> and regulations of the State of Minnesota and certifies that all statements made on this <br /> application are complete, true and correct. <br /> Signature of Applicant < I ' 7'eS Date: (6- <br /> MPCA License No.: 6 VD <br /> Staff Review: Accept ❑ Denied <br /> Reviewer: / // / ites <br /> ./ Date: /0 `' <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> V:\(Permits)\Septic System Permit Application.doc <br /> 2 / 2 <br />